[Post-radiation necrosis of the cricoid cartilage: an uncommon case]

Radiation therapy is considered as the treatment of choice for early stage laryngeal cancer. However, a few patients, after several years, develop severe life threatening complications, like edema or chondronecrosis. The clinical examination or endoscopy follow up may be difficult. CT and MR imaging can show the exact diagnosis depicting exquisitely the anatomy of the larynx. But at the beginning, the abnormalities are radiographically subtle and their diagnosis may be difficult because of artefacts due to patient dyspnea and mucous secretions. The main suggestive imaging features for suspecting a chondronecrosis seem to be the lost of normal signal hyperintensity on T1 MR imaging or a focal lack of cortical bone on CT scans, just adjacent to a focal swelling of the pharyngo-larynx mucosa. The barium pharyngography remains the best imaging diagnosis procedure for depicting associated abnormal communication between the digestive tract and the adjacent spaces or the cartilages of the larynx. Therefore, when the diagnosis is delayed, only salvage total laryngectomy can stop the infectious process. We report one case of a cricoid cartilage chondronecrosis eleven years after radiation therapy for laryngeal cancer.